Home Posts tagged "Inside-Out"

Black Friday/Cyber Monday Sale

I don't know about you, but I can't think of anything I would rather do less than get up at 4am and go stand in line at some store with thousands of other people to take advantage of some sale.  And, it's with that in mind that Mike Robertson, Bill Hartman, Mike Reinold, and I are proud to announce a sale through Monday (11/28) at midnight on the following products: Assess and Correct DVD Set Inside-Out DVD Set Magnificent Mobility DVD The Bulletproof Knees and Back Seminar DVD Set Building the Efficient DVD Set 2008 Indianapolis Performance Enhancement Seminar DVD Set The Single-leg Solution DVD Set and Manual Bulletproof Knees Manual and DVD Optimal Shoulder Performance DVD Set I've linked to each one of these products individually so that you can learn more about each of them, but you can purchase them individually or together easily at the Robertson Training Systems Product Page. The only exception would be Optimal Shoulder Performance, which can be purchased exclusively through www.ShoulderPerformance.com with the coupon code bfcm2011. If you're someone who is "new" to our products, I'd encourage you to check out this video on Assess and Correct to learn a bit more about how we roll with one of these products.  Assess and Correct is a great place to start, if you haven't purchased any of our stuff yet:

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Getting Geeky with AC Joint Injuries

Getting Geeky with AC Joint Injuries Lately, I've gotten quite a few in-person evaluations and emails relating to acromioclavicular (AC) joint issues.  As such, I figured I'd devote a newsletter to talking about why these injuries are such a pain in the butt, what to do to train around them, and how to prevent them in the first place (or address the issue once it's in place). First off, there is a little bit about the joint that you ought to know.  While the glenohumeral joint (ball-and-socket) is stabilized by a combination of ligamentous and muscular (rotator cuff) restraints, the AC joint doesn't really have the benefit of muscles directly crossing the joint to stabilize it.  As such, it has to rely on ligaments almost exclusively to prevent against "shifting."

ac-joint

As you can imagine, then, a traumatic injury or a significant dysfunction that affects clavicle positioning can easily make that joint chronically hypermobile.  This is why many significant traumatic injuries may require surgery.  While almost all Grade 4-6 separations are treated surgically, Grades 1-2 separations are generally left alone to heal - with Grade 3 surgeries going in either direction. In many cases, you'll actually see a "piano key sign," which occurs when the separation allows the clavicle to ride up higher relative to the acromion.  Here's one I saw last year that was completely asymptomatic after conservative treatment.  It won't win him any beauty contests, and it may become arthritic way down the road, but for now, it's no problem.

pianokeysign

Now that I've grossed you out, let's talk about how an AC joint gets injured.  First, we've got traumatic (contact) injuries, and we can also see it in people who bench like this:

Actually, that's probably a fractured sternum, but you can probably get the takeaway point: don't bounce the bar off your chest, you weenie.  But I digress... Insidious (gradual) onset injuries occur just as frequently, and even moreso in a lifting population.  Most of the insidious onset AC joint problems I've encountered have been individuals with glaring scapular instability.  With lower trapezius and serratus anterior weakness in combination with shortness of pec minor, the scapula anteriorly tilts and abducts (wings out) - and you'll see that this leads to a more inferior (lower) resting posture.

scapanteriortilt

In the process, the interaction between the acromion (part of the scapula) and clavicle can go a little haywire.  The acromion and clavicle can get pulled apart slightly, or the entire complex can get pulled downward a bit.  In this latter situation, you can also see thoracic outlet syndrome (several important nerves track under the clavicle) and sternoclavicular joint issues in addition to the AC joint problems we're discussing. As such, regardless of whether we're dealing with a chronic or insidious onset AC joint issue, it's imperative to implement a good scapular stabilization program focusing on lower trapezius and serratus anterior to get the acromion "back in line" with the clavicle.  Likewise, soft tissue and flexibility work for the pec minor can also help the cause tremendously. Anecdotally, a good chunk of the insidious onset AC joint problems I've seen have been individuals with significant glenohumeral internal rotation deficits (GIRD).  The images below demonstrate a 34-degree GIRD on the right side.

gird1gird2

It isn't hard to understand why, either; if you lack internal rotation, you'll substitute scapular anterior tilt and abduction as a compensation pattern - whether you're lifting heavy stuff or just reaching for something.  And, as I discussed in the paragraph above, a scapular dyskinesis can definitely have a negative effect on the AC joint. Lastly, you can't ever overlook the role of thoracic spine mobility.  If your thoracic spine doesn't move, you'll get hypermobile at the scapulae as a compensation - and we already know that's not good.  And, as Bill Hartman discussed previously, simply mobilizing the thoracic spine can actually improve glenohumeral rotation range-of-motion, particularly in internal rotation.  Inside-Out is a fantastic resource in this regard - and is on sale this week, conveniently! So, as you can see, everything is interconnected!  In part 2 of this series, I'll discuss training modifications to work around acromioclavicular joint problems and progress back to more "normal" training programs. New Blog Content Birddogs, Continuing Education, and Terrible Journalism Stuff You Should Read Exercise of the Week: Dumbbell Reverse Lunge Random Friday Thoughts It's All About Specialization All the Best, EC Sign-up Today for our FREE Baseball Newsletter and Receive a Copy of the Exact Stretches used by Cressey Performance Pitchers after they Throw!
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The Biggest Magnificent Mobility/Inside-Out Blowout Sale of All Time

As many of you know, Bill Hartman, Mike Robertson, and I are very close to releasing a new product.  In fact, we spent the weekend going through edits on the footage and pulling together the tag-along manuals. This new product includes a lot of our newer perspectives on assessment and corrective exercise.  Many of the drills we outline actually piggyback on those we outlined with our previous DVDs, Magnificent Mobility and Inside-Out.  There is even a bit of overlap where we discuss how the "older" drills fit into our up-to-date progressions. So, while the MM and I/O DVDs might be a few years old, the good news is that the human body hasn't evolved dramatically since then - so these drills are still highly effective.  However, with new products, older products sometimes get forgotten - and that's why we figured we'd throw out this opportunity to grab up these two previous products at a big discount. Here's the deal... 30% off on Magnificent Mobility and Inside-Out from Monday, August 31 through Wednesday, September 2.  All you need to do is head over to the RobertsonTrainingSystems.com Products Page and add the item(s) to your cart.  At checkout, enter the coupon code "FALL09" (all caps, no quotation marks) and the discount will be applied. Don't miss this last chance to get two great products at a great discount!
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Pain with Horizontal or Vertical Pushing?

Last week, I published a post on shoulder issues with overhead pressing, and got two good comments as replies: 1. In HS I separated my AC joint during the first game of junior year. I played the rest of the year with out letting it heal, and to this day I have still have shoulder issues (college ball didn't help the issue much either). It seems my shoulder allows me to overhead press/push press/jerk and incline press, but flat bench is out of the question unless I'm using DBs. Is this typical of this type of shoulder injury, or am I an outlier and most individuals show the same symptoms as yourself? Granted we each have different injuries but same local area. 2. I have pain doing flat bench presses with barbell and upright rows. Decline barbell press is also sometimes uncomfortable, but incline press and overhead press is working fine. This is actually pretty typical of acromioclavicular (AC) joint problems.  Folks will have problems with exercises like full-ROM bench presses and dips, as they force full humeral extension. Decline bench pressing requires less humeral extension on the eccentric than regular bench pressing and dips, so that would explain the decrease in symptoms. That said, overhead pressing will usually be okay because it doesn't require so much humeral extension (nothing past neutral).  However, some folks will have other related problems (e.g., rotator cuff injury during the AC injury), so both horizontal and vertical pushing movements may become problems. So, obviously, not all shoulder problems are created equal.  However, a lot of the time, they can be treated with similar means: good scapular stabilization movements, a focus on thoracic spine mobility, and dedication to strengthening the rotator cuff and improving soft tissue quality.

shoulder-performance-dvdcover

Click here to purchase the most comprehensive shoulder resource available today: Optimal Shoulder Performance - From Rehabilitation to High Performance.
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Random Friday Thoughts: 5/15/09

1. It's a fun time of year around Cressey Performance, as all the college guys are starting to roll back in, and the high school baseball playoffs are nearly at hand.  Brian St. Pierre was so excited about it that he tried to high five on of our power racks with his forehead.  He (and his three stitches) will be featured in the next episode of "When Power Racks Attack."

brianeyebrow

2. After I mentioned last week that Mike Robertson, Bill Hartman, and I had something in the works, I got several emails (and a stand-up question at the end of my talk at Perform Better last weekend) from people wanting to know what we were scheming up.  Suffice it to say that it's a sequel to Magnificent Mobility and Inside-Out, but on a whole new level.  If those DVDs were little league, this is going to be big league stuff, We'll have detailed assessments, progressions, and sport-specific protocols.  I guess you could say that it's somewhat of a "choose your own adventure" book where you can take multiple paths; and, in the case of trainers/strength coaches, you can help your clients/athletes out individually.  And, there will be a nice tag-along manual. We are hoping to get this kid to sing on the soundtrack, but his agent won't call me back.

Anyway, we've got over three years of accumulated "add-ons" from the initial MM DVD, and it's also the first time the three of us have put all our heads together on a project.  Should be very cool - and we are hoping for a mid-summer release date.  If you aren't already subscribed to my newsletter, definitely do so (with the feature over to the right of this page) and we'll make sure you're notified right away.  You can view a sample of this newsletter by checking out the one from earlier this week: Newsletter 154. 3. Mike Reinold has an awesome blog post series going about Anterior Knee Pain. Whether you're a strength coach, personal trainer, physical therapist, garbageman, orthodontist, or lazy wanker who just lives in his parents' basement, I'd highly recommend you check it out at MikeReinold.com. 4. One of the things I love the most about training pitchers is when they go out in the spring - after a winter of training to improve throwing velocity and prevent injury - and start hitting bombs at the plate.  Obviously, it's awesome for their confidence, but just as importantly, it's proof in the pudding that simply enhancing overall athleticism will carry over to just about anything. If a kid only goes from 78 to 88mph on the mound, he tries to attribute it solely to a change in mechanics or lots of rubber tubing drills for his rotator cuff.  However, if he starts hitting 400-foot shots alongside that velocity increase, you know he'll start to appreciate that the extra 20 pounds of meat on his butt, hamstrings, and upper back - and the big strength increases - are all playing a part in that improvement. That's all.  Have a great weekend!

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The Most Detailed Maximum Strength Feedback To-Date

I received this email from Kevin Miller, a high school strength and conditioning coach in Pennsylvania, who recently completed the Maximum Strength program: I recently completed the 16 week Maximum Strength program by Eric Cressey, and I wanted to give my review on the program. I am 37 years old. I played H.S football and baseball and had good strength and speed. From 1995-2004 I switched gears and became an Endurance athlete (marathons and Iromans). I had great endurance and could run forever but I went from probably a 28-29 inch vertical to probably a 19-20 inch vertical. Over the past few years I have jumped back and forth from endurance to strength programs. I saw results in both but I never stuck to one program. Two years ago I purchased Inside-Out by Mike Robertson and Bill Hartman. I thought it was a great program, so I started to read more about Mike, and in turn, Eric - and was instantly impressed with what he had to say, as I'm a volunteer sports performance coach at the high school where I teach. Over the past year I have read his articles and watched his DVDs, so, when Max Strength came out I was hooked and decide to STICK to a program. Below are my results (Pre and Post) PRE------------------------------------------------------------------------------------------POST BW                               146 lbs                                                 151 lbs Broad Jump                88 inches                                         94 inches (6 inches) Bench Press                 195                                                      220 (25 lbs) Box Squat                    255                                                      325 (70 lbs) Deadlift                        275                                                      315 (40 lbs) Three rep Chin up        BW + 44 lbs                                       BW + 58 lbs (19 lbs) Notes/Comments: Overall, I was very pleased with the results. As far as BW, I was happy to gain 5 lbs, to be honest. I am a father with two kids and a third on the way. I never get to slow down. After school (I trained in the morning before school), I'm in the weight room with high school kids for 2 hrs (boys and girls). Although I am not "training," I probably do 100 body weight squats plus several other movements because the kids need to see what I'm recommending. Physically although I only gained 5 lbs I look bigger, but not bulky - just thicker and more athletic Overall, out of a rating of 10. I would give this program a 10. Here is why: 1. If you follow it, you will get STRONGER. The book is MAXIMUM strength, and it does what it says it does. 2. I feel really strong. Before, I had decent strength, but now I just feel a lot stronger 3. The mobility part is excellent. I knew what to expect here since I have several of Eric's products but this is where so many people can benefit (especially high school kids). I never stretched a day in my life in hs. Now, I would never start a workout with doing mobility work. 4. As a coach, I became a better coach by doing this program. Plain and simple, I now know how it feels to get under the bar with 325 lbs on my back. I realize that's a warm-up for some people but for me at 150 lbs it's a lot. 5. The progressions are excellent. 6. Nutritionally, there is some great advice in the book. To be honest, I think I've always had a good diet but for anyone who doesn't there are some great points. Who can benefit from this book? 1. Any high school kid or "Mom/Dad" looking for strength and results. 2. Any high schools coach (football, track, hockey,etc). As much as we would like to "customize programs" for each athlete, it's impossible at the high school level. I train 50-60 kids at 3 pm, and at my school, I don't have the time, manpower, or money to make up individual programs. Sure, I can screen kids and put in groups, but I believe if high school kids followed this for 16 weeks, it would be better than 95% of the program they are currently following Favorite exercises I never did before I read this book:
  1. Rack pulls: I loved the feeling I got in my posterior chain
  2. Pallof Press: Much harder than it looks
  3. Anderson squats: I loved this type of front squat.
Overall, great book, and if you follow this program, you will get stronger Kevin Miller CSCS

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Lifting after Shoulder Surgery

Q: I've found your articles on T-Nation very informative, and enjoy the format you use to convey your message (with humor!). My specific interest is in the information you provide about your shoulder problems, as you've noticed in the subject line I recently had my shoulder scoped in February to repair a labral tear. I did the required PT, and then when that was finished they pretty much sent me out on my own and said only do internal and external rotations for delts/rotator cuff. Overhead pressing and upright rows will supposedly cause problems according to the therapist (but I question this). I've read in your articles that the shoulders get plenty of work from chest and back/lat exercises, and that external rotation variations may be adequate, with occasional presses and laterals. Can I do dumbbbell presses with palms facing in to reduce shoulder pain, as well as laterals for the middle/posterior heads without causing problems? I seem to be progressing fairly well with higher rep sets on my upper body, but want to make sure I do the correct things to set myself up for a lifetime of healthy lifting and stable shoulders. A: If I am you, and I have a shoulder surgery, I can the overhead pressing for good. And, I think upright rows are quite possibly the single worst exercise for shoulder health. I wrote about this HERE - but the short version is that you don't want to go through abduction (especially above 90 degrees) with the humeral head maximally internally rotated. Dumbbell bench pressing (not overhead pressing) is fine - and the lateral raises should be okay as long as you stay in the scapular plane. Check out my Shoulder Savers series at T-Nation for details on that front. And, above all else, you need to buy the Inside-Out DVD. It sounds like you are getting way too "rotator cuff-focused" and are ignoring a bunch of other factors that are incredibly important for shoulder health; these include thoracic spine range-of-motion and scapular stability (among other things). Shoulder health is about more than just getting stronger "all over;" it's about optimizing range-of-motion and muscular balance. It would definitely be a good investment - and much cheaper than another shoulder surgery!
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Random Friday Thoughts: 7/18/08

1. Here’s a great article on the potential drawbacks of yoga. I’ve written about this before, but it’s nice to see someone else providing a "user’s perspective." 2. My girlfriend deadlifted 250 and benched 135 this week. She’s awesome and I’m the luckiest guy in the world. 3. I’ve written about it before, and I’m going to reiterate it again: Vitamin D supplementation is going to be the next big thing. The typical 400IU dosage doesn’t appear to be enough; there’s a solid benefit for most to up that to 1,000IU/day or slightly more. In some serious clinical deficiencies, they’ll go on some insane dosages. 4. The All-Star Break has just finished up, but I’m already as excited as a little kid on Christmas when I think about our crew of pro baseball guys for the upcoming off-season. We’re going to be kicking out studs for years to come. If you're a ballplayer (or other athlete, for that matter) with interest, drop us an email at cresseyperformance@gmail.com. 5. Brian St. Pierre attempted to become the first person to ever get me to puke with training program with an insane pseudo-Strongman medley at the facility on Tuesday. It was to no avail, though; I only dry-heaved, so the perfect record is intact. Thanks for playing, Brian. 6. I really can’t stand the phrase "It is what it is." What the heck does that mean? "I’m too lazy to finish this sentence or come up with another useful thought." 7. Mike Robertson and Bill Hartman are offering a SWEET discount on their Inside-Out Product Line. As you probably know, as a "shoulder guy," I'm a huge fan of the drills in this DVD. Through 7/21, if you go HERE, add it to your cart, and enter the code IFAST in the discount code box at the right, you'll get 40% off the DVD and/or manual.
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Prevent Striking Injuries

Q: Technique aside, what is your prescription for combat sport athletes looking to prevent injury from striking? To clarify; when myself and a few of my boxing brethren hit the super-heavy bag, or the firm thai pads, we often feel the reverberation in our arms and rear delts. Personally, I have an injury to my left shoulder, which means any impact reverberation is extra bad and cuts my workouts down to about three minutes (less if I'm doing low hooks). I know that some of the others have similar problems, mine is just more acute thanks to the bum shoulder. I don't feel this when hitting other people, or the softer bags, only the heavy duty, or extra thick ones. If you have any suggestions as to what work we should do to prevent this turning into injury, we'd all appreciate it. A: Something interesting for you. I work with a local high profile theatrical performance group that involves a lot of drumming. These guys have more upper extremity issues than anyone I've ever seen - baseball players included – and that's a really screwed up population). Is striking a thai pad anything more than a really hard drumming stroke in terms of the force dissipation? I've had good success with those guys with getting maximal strength up; check out this article where I talk about the role of maximal strength in the law of repetitive motion (“F” is expressed as a percentage of maximal strength; get tissue stronger, and each rep is perceived as less challenging overall). In particular, I’m talking strength of the elbow flexors (biceps, etc), upper back, “core,” and larger muscles from the hip-down. Soft tissue work is huge at the forearms/elbow (flexor carpi ulnaris, flexor carpi radialis, pronator teres, anconeus) and shoulder (pec minor, long head of triceps, coracobrachialis, subscapularis, infraspinatus/teres minor, and levator scapulae). I love the movements on the Inside-Out DVD; we've used it with great success. Tags: shoulder pain, combat athletes, drumming, baseball, Inside-Out, boxing, heavy bag
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Correlating Pec Tears and Benching

Q: Is there any reason why there is such a big incidence of pec tears during benching in comparison to shoulder/triceps/lat tears, especially if powerlifting style is supposed to de-emphasize the use of the pecs? A: Research at Indiana University found that cross-sectional area of the subscapularis is the best predictor of powerlifting performance, believe it or not. If you're getting that much hypertrophy of the subscapularis, it's doing a lot of work - and for a small muscle. Ask any manual therapist, and they'll tell you that subscapularis is always balled up - and frequently shuts down due to repetitive microtrauma. Shut subscapularis down, and pec major will work overtime as an internal rotator of the humerus. Reference Shirley Sahrmann's work; if you see an strained/tight muscle, look for an underactive synergist. You'll also get a humeral anterior glide, and additional tightness/restrictions on infraspinatus/teres minor. So, the name of the game is to activate subscapularis with exercises like those in Inside-Out, and also improve the length and tissue quality of your external rotators. Eric Cressey
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